质子重离子联合免疫治疗在恶性肿瘤治疗中的理论研究进展

Theoretical advances in proton heavy ion combined immunotherapy in the treatment of malignant tumours

放射治疗联合免疫治疗是目前最有前景的肿瘤治疗方法之一。粒子束(质子和重离子)作为一种新兴的肿瘤治疗方法,主要是通过提高免疫治疗的疗效,从而更有效地诱导肿瘤细胞凋亡。然而,临床前和临床研究表明,与常规放疗相关的潜在免疫抑制机制可能会限制其免疫潜力。质子重离子作为带电粒子,在正常细胞和肿瘤细胞中所表现出来的剂量和生物学差异,不仅能够增强放疗的免疫辅助作用,还能降低免疫抑制机制。所以理论上来讲,粒子束联合免疫治疗的疗效不劣于常规放疗联合免疫治疗的疗效,但目前在临床上并没有得到广泛的使用。本文就常规放疗或粒子束治疗联合免疫治疗的抗肿瘤作用及其机制的研究进展作一综述。

Radiotherapy combined with immunotherapy is one of the most promising tumour treatments available.Particle beams(protons and heavy ions),as an emerging oncological treatment,are mainly used to more effectively induce tumour cell apoptosis by enhancing the efficacy of immunotherapy.However,preclinical and clinical studies suggest that the underlying immunosuppressive mechanisms associated with conventional radiotherapy may limit its immunological potential.The dosimetric and biological differences exhibited by proton heavy ions as charged particles in normal and tumour cells could not only enhance the immunoadjuvant effect of radiotherapy,but also reduce the immunosuppressive mechanisms.Therefore,theoretically,the efficacy of particle-beam combined immunotherapy is not inferior to that of conventional radiotherapy combined with immunotherapy,but it is not widely used in the clinic at present.This paper reviews the research progress on the anti-tumour effect of conventional radiotherapy or particle-beam combined immunotherapy and its mechanism.